Moffitt Cancer Center, Departments of Breast Oncology and Health Outcomes and Behavior, Tampa, Florida, USA.
Johns Hopkins University, School of Medicine, Department of Oncology, Baltimore, Maryland, USA.
J Palliat Med. 2021 Nov;24(11):1714-1720. doi: 10.1089/jpm.2021.0115. Epub 2021 Aug 17.
There are racial/ethnic disparities in hospice use and end-of-life (EOL) care outcomes in the United States. Although the use of community health workers (CHWs) and patient navigators (PNs) has been suggested as a means of reducing them, CHW/PNs' attitudes toward a palliative care philosophy remain unknown. The purpose of this study was to examine how personal attributes affect a CHW/PN's attitude toward EOL care. CHWs/PNs were recruited from two state-wide organizations and invited to complete an online survey. We collected information on demographics, attitudes toward the palliative care philosophy, and comfort with caring for patients at the EOL. Of the 70 CHWs/PNs who responded to the survey, 82.5% identified as female, 56.4% identified as black, and 56.2% had a four-year college degree or higher. The mean score on a validated scale to assess attitudes toward EOL care was 33.5 (SD = 4.9; possible range, 8-40). Eighty percent strongly agreed or agreed with being open to discussing death with a dying patient. Higher self-efficacy scores were associated with more favorable attitudes toward hospice ( = 0.306, = 0.016). CHWs/PNs have an overall favorable attitude toward the palliative care philosophy and may be inclined to providing EOL care.
在美国，临终关怀的使用和临终护理结局存在种族/民族差异。尽管有人建议使用社区卫生工作者（CHWs）和患者导航员（PNs）来减少这些差异，但 CHW/PN 对姑息治疗理念的态度尚不清楚。本研究的目的是探讨个人属性如何影响 CHW/PN 对临终关怀的态度。CHWs/PN 从两个全州性组织招募，并邀请他们完成在线调查。我们收集了有关人口统计学、对姑息治疗理念的态度以及在临终关怀中照顾患者的舒适度的信息。在回应调查的 70 名 CHWs/PN 中，82.5%为女性，56.4%为黑人，56.2%拥有四年制大学学位或更高学历。评估临终关怀态度的有效量表的平均得分为 33.5（SD=4.9；可能范围为 8-40）。80%的人强烈同意或同意与临终患者讨论死亡。自我效能得分越高，对临终关怀的态度越有利（ = 0.306， = 0.016）。CHWs/PN 对姑息治疗理念总体持积极态度，可能倾向于提供临终关怀。
